Health Literacy: Exploring nursing challenges to providing support and understanding

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As patient advocates, oncology nurses must attend to varying levels of health literacy among patients and families. However, little is known about nurses’ experiences and comfort with health literacy assessment and providing health literacy support.


The purpose of this study is to explore nurse communication and patient health literacy.


A cross-sectional survey design (N = 74) was used to explore nurse communication challenges with low-literacy patients and to measure nurses’ frequency of assisting with patient literacy needs, perceived degree of difficulty communicating with low-literacy populations, and perceived comfort with health literacy support.


A majority of the nurses reported communication challenges with patients who spoke English as a second language. Oncology nurses did not identify patient communication behaviors that indicated low health literacy. Nurses were least comfortable identifying low-literacy patients and assessing a patient’s health literacy level. More experienced nurses reported more difficulty with low-literacy populations than less experienced nurses. Providing health literacy support to patients should be a core nursing skill.

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